It’s pretty clear, the U.S. healthcare system is in need of a major upgrade. Spending increased 4.3 percent in 2016 to $9,024 per capita and accounted for 17.9 percent of the GDP. To give some perspective, Switzerland, with its comprehensive and well-organized (it is Swiss, after all) system came in second, with individuals paying on average $6,787, or about 75 percent of what we do.

You could almost justify paying such a high price, except for the tragic reality that our outcomes are so bad. According to a recent Los Angeles Timesarticle, the U.S. life expectancy is now shorter than 30 other countries', we ranked 13th in medical coverage and more people died in the U.S. from preventable diseases or complications than in 12 other high-income countries -- all in all, pretty grim statistics, given that almost a fifth of our GDP and a fair amount of your paychecks are going to healthcare costs.

With such abysmal statistics, healthcare’s impact on productivity and the bottom line and the small fact that global spending on healthcare is now on course to reach more than $18 trillion in 2040, it’s little wonder that Amazon, Apple, Google and Facebook are all vying for their place in the often chaotic, ever-growing health marketplace.

Alexa, how do I get to the nearest Amazon clinic?

In case you stopped reading the news or turned off Alexa, Amazon recently made a few very well-publicized healthcare moves. One of the most highly touted was its decision to partner with Berkshire Hathaway and JPMorgan Chase to create a new company to provide lower-cost, higher-quality healthcare for its 840,000 employees. While seemingly small in the scope of the overall market, if successful, it could serve as a model for the future of care and potentially disrupt the health system as we know it.

As if changing the face of healthcare wasn’t enough, in June it was reported that Amazon intended to pay $1B to acquire Pillpack and enter the growing $328B annual prescription drug market. Given Pillpack’s strong infrastructure and Amazon’s logistics capability, it’s not surprising that this simple statement sent Walgreens, CVS and Rite Aid’s stock prices plummeting up to 11 percent.

These announcements come in addition to the work that Amazon has already quietly been doing the past few years, including the creation of 1492. Though little has recently been written about it, the entity was designed to help Amazon develop its presence in a number of lucrative healthcare markets. In particular, it was reported that its staff was working to streamline medical records management to improve access and availability for doctors and consumers. Additionally, it was said to also be looking at ways to improve U.S. healthcare for those with limited access to doctors, including the development of a new telemedicine platform to provide virtual consultations.

Finally, what report on Amazon would be complete without mentioning dear Alexa. The company continues to look at new ways to use Alexa’s growing AI capabilities to address some of the world’s most critical healthcare challenges. Initiatives include helping patients manage their diabetes and supporting initiatives to use it to help the elderly in their homes.

AppleCare takes on a whole new meaning.

Not to be left out, in January 2018 Apple announced that it would be bringing personal health records to an iPhone near you…which basically means everywhere. At last check, nearly 40 health systems had given access to patients to view their medical records on their iPhones, a big increase from the initial 12 health systems that had signed before the company announced in January.

This was soon followed by the announcement that Apple would be launching its own primary care clinics, called AC Wellness, to address the needs of its more than 120,000 employees. The clinics were supposed to open in the spring, and some 40 staff have already been hired in anticipation, including several former Stanford Health Care employees.

Needless to say technology will play a big part in AC Wellness’ offerings. According to CNBC sources, it is expected that Apple will use its new clinics not only treat its staff but to “test out its growing range of health services and products.” These new ventures come as part of a natural progression in Apple’s years of experience with its Health app and Apple Watch. It firmly places this comparatively trusted company in a good position to help disrupt healthcare’s growing market.

Dr. Google diagnoses what’s wrong with healthcare.

It is virtually (yes, I went there) impossible to determine how deeply Google is involved in the healthcare space. Over the years, Google has created, funded and/or partnered on a variety of health-related projects, with different degrees of success…Google Glass, anyone? But one thing is clear -- it is committed to changing the future of healthcare for the better.

As part of this effort, in 2009 it launched Google Ventures, the venture capital arm of Alphabet, Inc. The fund currently has about $2.4 billion to spend and has made investments in at least 300 companies, frequently related to the areas of genomics, biotechnology and cell therapy. Its growing interest is most clearly evidenced by its spending. In 2012 and 2013 the fund invested only 9 percent of its capital in healthcare companies, but that number quickly jumped to 36 percent in 2014.

Google’s commitment was further demonstrated with the 2015 founding of Verily, formerly part of Google X. With an understated yet powerful mission statement “to make the world's health data useful so that people enjoy healthier lives,” the company has taken on many of the world’s most critical health challenges both on its own and with partners. From sensors to health platforms to precision medicine, the company is seeking to “transform the way healthcare is delivered.”

And if all of that wasn’t enough, between 2013 and 2017, Alphabet filed 186 healthcare patents. So don’t be surprised that when you google healthcare, “Google” appears at the top of your results.

Facebook

Facebook’s entry into the healthcare space has been perhaps the most uneven and seemingly secretive of all the “Big 4.” Though it is clearly determined not to miss this opportunity, its results haven’t always been positive.

In the last few months, the company had been said to be talking to several major hospitals, including Stanford Medical School and American College of Cardiology, about working on a data-sharing agreement. The idea was to share anonymized data that Facebook would match against its user data to help the hospitals determine which patients might be in need of special care or treatment.

Though potentially useful for patients, the project posed potential new, unwelcomed questions about Facebook’s collection and use of user data, in the wake of the recent Cambridge Analytica scandal. It never made it out of the planning phases.

Prior to this, Facebook used its vast platform for healthcare projects from genomic testing to public health. It provided an app for the University of Michigan’s genetic testing program through the University of Michigan, called “Genes for Good.” It sent medical reminders and encouragement from clinicians and peers to teens with asthma — with the participants showing marked improvement. And it helped develop patient communities around specific conditions and supported organ and blood donation programs like Social Blood.

While it’s not clear what the future holds for Facebook in the healthcare space, given the public’s concern around its data privacy issues, it is clear that the company is actively exploring opportunities and has been said to be working on new initiatives in its "Building 8" experiment projects group.

The Prognosis

While this is by no means a complete list of what is being planned and/or implemented by these ubiquitous tech giants, it’s a good indication of their intention and ability to change healthcare as we know it. Undoubtedly, there are pluses and minuses to having them as intricately involved in our health as they are in other aspects of our lives -- only time will tell.

Over the past few years, we’ve seen them seize and capitalize on opportunities, often creating solutions beyond our wildest dreams…and, at times, our greatest nightmares. Within all this, it’s important to note that we are talking about our health and health information …and there’s rarely an opportunity for an upgrade or a reboot for either.

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